Attachment C Familial Statement.pdf
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- Attached to
- GISD Server Hardware 2026 RFP
- Solicitation number
- RFP GIS 260000001462 1
- Issued by
- Genesee County, Michigan
About this file
This is a Familial Relationship Disclosure Statement form required by the Genesee Intermediate School District (GISD) in Flint, Michigan, in compliance with Public Act 232 of 2004. The statement must accompany all bids submitted in response to the GISD Server Hardware 2026 RFP. The form serves as a sworn and notarized disclosure document requiring bidders and their employees to identify any familial or business relationships with members of the GISD Board of Education, the District Superintendent, or any other District officials. Any bid submission that does not include a completed and notarized familial relationship disclosure statement will be rejected and deemed non-responsive.
The form requires bidders to provide their company name and address, contact information, and a detailed statement of any business or familial relationships. A person authorized to bind the contractor must sign the document, which must then be notarized by a notary public in the appropriate county. The notary must provide their signature, commission expiration date, and indicate the county in which they are acting. This disclosure requirement applies uniformly to all respondents and is mandatory for bid acceptance.
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Text version
GENESEE INTERMEDIATE SCHOOL DISTRICT
ERWIN L. DAVIS EDUCATION CENTER
2413 WEST MAPLE AVENUE
FLINT, MI 48507-3493
PUBLIC ACT 232 OF 2004
FAMILIAL RELATIONSHIP DISCLOSURE STATEMENT
All bids must be accompanied by a sworn and notarized statement disclosing any familial, or other business relationship existing between the bidder (respondent to this Bid) and all employees of the bidder and any member of the Genesee Intermediate School District Board of Education, the Superintendent of the District and/or any other official of the District. Any bids that do not include this sworn and notarized statement shall not be accepted.
Owner Name & Address:
Genesee Intermediate School District 2413 West Maple Avenue
Flint, MI 48507-3493
Contractor/Vendor/Respondent Information:
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Contact Number: ______________________________________________________________
Statement of Business or Familial Relationship:
Person Authorized to Bind the Contractor/Vendor/Respondent:
Print Name Title
Signature Date
Seal:
This instrument was acknowledged before me, a Notary Public, in and for ___________________________ County, _____________________ on this _________ day of ________________________, 20_________.
State
Notary Public Signature Date
My Commission Expires: _______________________
Acting in the County of: ________________________
Attachment C
File details come from the government source that posted it. Updated .